Risk factors and outcomes of ventilator-associated pneumonia in neonates
Keywords:
Neonatal intensive care unit (NICU), newborn, outcome, risk factor, ventilator-associated pneumoniaAbstract
Introduction: Ventilator-associated pneumonia (VAP) has a high incidence in infection among neonatal intensive care unit (NICU) patients and significant morbidity and mortality in NICU.
Objectives: To establish the incidence of VAP in neonates and compare risk factors and outcomes between the VAP and non-VAP groups of patients. Methods: A retrospective study, all neonates mechanically ventilated for more than 48 hours and were admitted in NICU of Thung Song hospital since 1 January 2015 to 31 December 2017. The data was collected from medical records and chest x-ray. Results: There were 153 neonates enrolled. There were 32 VAP patients (44 episodes) and 121 non-VAP. VAP occurred in 26.6%, at a rate of 22.1 per 1000 ventilator days. According to the multivariate analysis, bronchopulmonary dysplasia (BPD) (AdjOR = 39.74, 95% CI 14.35-110.02; P = 0.000) and sedative medication use (AdjOR = 4.99, 95% CI 1.54-16.16; P=0.007) were independent risk factors for VAP. Patients with VAP had a longer duration of mechanical ventilation (37.5 days vs 4 days; P=0.000), length of hospital stay (49 days vs 20 days; P 0.000) and higher hospitalization costs (273,920 baht vs 75,430 baht; P=0.000)
Conclusion: BPD and sedative medication use were independent risk factors for VAP. Furthermore, the VAP patients had a longer duration of mechanical ventilation, length of hospital stay and higher hospitalization costs.
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